MEDICARE: CALEB CALHOUN APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	NUR-APRN-LIC-219390	MT

General Provider Information

NPI Number	:	1326820812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CALEB CALHOUN APRN

Provider Business Mailing Address
First Line	:	PO BOX 31001
Second Line	:	4114
City	:	PASADENA
State	:	CA
Zip	:	91110-4114
Country	:	US
Telephone Number	:	406-327-3362
Fax Number	:	406-327-3349

Provider Business Practice Location Address
First Line	:	900 N ORANGE ST STE 202
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59802-2951
Country	:	US
Telephone Number	:	406-327-3362
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2023
Last Update Date	:	01/26/2026

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